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Sexuality and Physical Changes With Aging

Topic Overview

Sex and sexuality communicate a great deal:
affection, love, esteem, warmth, sharing, and bonding. These gifts are as much
the right of older adults as they are of those who are much younger.

Three aspects of sexuality are covered in this topic: the changes that
come with aging, suggestions on how to adjust to these changes, and information
about
sexually transmitted infections.

In most
healthy adults, pleasure and interest in sex do not diminish with age. Age
alone is no reason to change the sexual practices that you have enjoyed
throughout your life. But you may have to make a few minor adjustments to
accommodate any physical limitations you may have or the effects of certain
illnesses or medicines.

Common Physical Changes in Men

Most physical changes
are the result of gradually decreasing
testosterone levels. These changes affect energy,
strength, muscle and fat mass, bone density, and sexual function.

A man's sexual response begins to slow down
after age 50. But a man's sexual drive is more likely to be affected by
his health and his attitude about sex and intimacy than by his
age.

It may take longer for a man to get an erection, and more time
needs to pass between erections.

Erections will be less firm.
But a man who has good blood flow to his penis will be able to have
erections that are firm enough for sexual intercourse throughout his entire
life. For more information, see the topic
Erection Problems (Erectile Dysfunction).

Older men are able to
delay ejaculation for a longer time.

Common Physical Changes in Women

Most physical
changes take place after
menopause and are the result of decreased estrogen
levels. These changes can be altered if a woman is taking
hormone therapy.

It may take longer for a woman to become
sexually excited.

The walls of the vagina become thinner and drier
and are more easily irritated during sexual intercourse.

Orgasms
may be somewhat shorter than they used to be, and the contractions experienced
during orgasm can be less intense.

Not all women experience these problems. Those who do can
experiment to find ways to enjoy sex despite these physical changes.

Cultural and Psychological Factors

In addition to
physical changes, there are cultural and psychological factors that affect
sexuality in later years. For example, in our culture, sexuality is equated
with youthful looks and youthful vigor. Too many people seem to think that as a
person ages, he or she becomes less desirable and less of a sexual being. Older
adults may accept this stereotype and buy into the notion that they are not
permitted or expected to be sexual.

Joy in sex and loving knows no
age barriers. Almost everyone has the capacity to find lifelong pleasure in
sex. To believe in the myth that older people have no interest in sex is to
miss out on wonderful possibilities.

Being single through choice,
divorce, or widowhood can present a problem also. As you get older, you may
not have as many people in your age group to choose from for partners. Women
and men who are single may not know how to deal with their sexual feelings.
Generally speaking, it is better to express your desires than to suppress them
until you are no longer aware that they exist.

Physical and
emotional needs change with time and circumstance. Intimacy and sexuality may
or may not be important to you. The issue here is one of choice. If you freely
decide that sex is no longer right for you, then that is the correct decision.
It is possible to live a fulfilling life without sex. But if you choose to
continue enjoying your sexuality, you deserve support and encouragement. You
may still find uncharted sensual territories to explore.

Staying Sexual

Just as exercise
is the key to maintaining fitness and health, having sex on a regular basis is
the best way to maintain sexual capacity.

And just as it's never
too late to start an exercise program, it's never too late to start having sex.
Many older people who have been celibate for years develop satisfying sexual
practices within new loving relationships. For others, self-stimulation
(masturbation) is common and poses no health risks or side effects.

You may have sexual changes as you get older. But some changes may be the
first sign of a medical problem. So talk with your doctor about any changes
that concern you. He or she may be able to recommend treatments that will help
you.

Here are some other considerations:

To enhance sexual response, use more foreplay
and direct contact with sexual organs.

The mind is an erogenous
zone. Fantasy and imagination help arouse some people. Try setting the mood
with candlelight and soft music, or whatever else "turns you
on."

Many medicines, especially high blood pressure medicines,
tranquilizers, and some heart medicines, inhibit sexual response. Ask your
doctor about these side effects. Your doctor may be able to reduce your dosage
or prescribe different medicines. Do not stop taking prescription medicines
without talking with your doctor first.

Colostomies, mastectomies,
and other procedures that involve changes in physical appearance need not put
an end to sexual pleasure. Communicating openly about your fears and
expectations can bring you and your partner closer together and help you
overcome barriers. If needed, a little counseling for both of you can help
you adjust.

People who have heart conditions can enjoy full,
satisfying sex lives. Most doctors recommend that you abstain from sex for only
a brief time following a heart attack. If you have
angina, ask your doctor about taking nitroglycerin
before you have sex. Do not take Viagra if you are using
nitroglycerin.

If arthritis keeps you from enjoying sex, experiment
with different positions. Try placing cushions under your hips. Also try home
treatment for arthritis pain. For more information, see the topic
Osteoarthritis.

Use a water-based vaginal lubricant, such as Astroglide or K-Y
Jelly, to reduce vaginal dryness or irritation. Do not use petroleum jelly. A
doctor can also prescribe a vaginal cream containing estrogen, which will help
reverse the changes in the vaginal tissues.

Prescription medicines that can enhance the sexual response are
available. Some people find that herbs such as
ginkgo biloba and ginseng enhance their sexual
function. Both prescription drugs and herbal remedies carry the risk of side
effects. Always talk to your doctor before you use any new medicines or supplements.

Other Aspects of Sexuality

Sexuality goes far beyond
the physical act itself. It is part of who we are. It involves our needs for
touch, affection, and intimacy.

Touch

Touch is a wonderful and needed sensation.
Babies who are not touched do not thrive. Children who are not touched develop
emotional problems. Touch is important to older adults as well. Touch helps us
feel connected with others and enhances our sexuality.

Get a massage. Professional massages are
wonderful, but simple
shoulder and neck rubs feel great, too. Find a friend
who will trade shoulder rubs with you.

Look for hugs. Everybody
needs them. Some people are a little shy about hugs, but it's okay to ask,
"Would you like a hug?"

Consider getting a pet. Caring for a pet
can help meet your needs for touch. Some studies have shown that older people
who have pets to care for live longer.

Affection

To give and receive affection is a
wonderful feeling. If you like someone, be sure to let them know. If someone
seems to like you, appreciate it. It is never too late to make new friends and
strengthen bonds with longtime companions.

Intimacy

Intimacy is the capacity for a close
physical or emotional connection with another person. Intimacy is a great
protector against
depression.

Talking with a confidant can
help ease life's problems. When you lose a loved one, intimacy may be what you
miss most. You may not find someone to fully replace a loved one who died, but
you can begin to rebuild intimacy in your life in the following ways:

Turn to your children, siblings, or old and
new friends.

Look for another person who is in the same situation
as you are. One of the richest benefits of
support groups is that members often find intimacy
with one another.

Be available to others. Just as you need people,
there are people who need you too.

Sexually Transmitted Infections

Sexually transmitted infections—also known as STIs or
venereal diseases—are infections passed from person to person through sexual
intercourse, genital contact, or contact with semen, vaginal fluids, or
blood.

Older people may think of STIs as a problem that affects
only young people. But because of physical changes related to age, older adults
who are exposed to STIs may be more likely than young people to get STIs.

As you age, your immune system is not as strong, so it's harder to
fight off disease. And women who are past menopause have thinner vaginal walls
and less vaginal moisture than they did before menopause. Using a lubricant,
such as K-Y Jelly, may keep you from getting a sore or a tiny cut on your penis
or inside your vagina. This can reduce your risk of getting STIs or
HIV.

Practice safer sex. For older adults,
this means always using
condoms and lubricants until you are in a monogamous
relationship and know your partner's sexual history and HIV status.

STIs can affect anyone, no matter what his or her age. Talk openly with
your partner about STIs, and take whatever precautions are needed to protect
yourself before you engage in any form of sexual contact. If you
think you may have an STI, see your doctor.

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